Informed consent
Why is it so hard to judge whether a child can consent?
Open access · cc by · source: Europe PMC
We still have no reliable way to tell when a child can give valid medical consent, and the authors argue that systematic measurement, not more theoretical debate, is the way forward.
Study at a glance
- Design
- Other — Argumentative debate paper drawing on legal, developmental and empirical literature to propose a research agenda
- N
- No participants; a position paper, not a systematic review
- Population
- Children and adolescents' competence to consent to medical treatment and clinical research
- Outcome
- Thesis: progress requires standardized empirical assessment of children's competence rather than further purely normative debate
Structured fields used in claim comparison tables when every cited study has a complete layer.
Key findings
Legal age limits for consent vary widely between countries and look partly arbitrary, since some children below the limit are competent and some above it are not. Development research suggests adolescents gain abstract reasoning but still differ from adults in impulse control and weighing long-term consequences, and that illness experience, parents and peers affect decisions. Only two studies had assessed children on all four standard competence criteria. The authors recommend a structured multidimensional tool like the MacCAT, children from 7 to 18, real rather than hypothetical decisions, varied risk levels, and measures of context and intelligence.
Methodology
The authors examine why the question of children's decision-making competence has stalled, looking in turn at normative and legal aspects, child development, existing empirical data and practical barriers. They then set out recommendations for a research agenda.
Limitations
The paper reports no new data and its literature coverage is not systematic, so its picture of the evidence may be incomplete. It argues that empirical work can break the impasse, but measurement alone cannot settle normative questions such as how much competence should be required for high-risk decisions. The recommendations lean heavily on adult tools, which may not capture what matters for children. It also leaves open whether consent to research should be judged more strictly than consent to treatment.
How this study connects
Role on claims
Each row is a claim on a concept or method page where this paper supports, challenges, or qualifies the statement. Roles are hand-checked — not a model guess.
We know surprisingly little, empirically, about when children can consent.
A critical review finds legal consent ages vary widely between countries and look partly arbitrary, and that only two studies had assessed children on all four standard competence criteria; the authors call for a structured multidimensional tool, children aged 7 to 18, and real rather than hypothetical decisions.
Evidence for the claim as stated.
History
When this study was placed
Dated entries from the concept change log — when this paper was added or removed as support, challenge, or qualifier on a claim.
Placed as supporting evidence on Informed consent
A critical review finds legal consent ages vary widely between countries and look partly arbitrary, and that only two studies had assessed children on all four standard competence criteria; the authors call for a structured multidimensional tool, children aged 7 to 18, and real rather than hypothetical decisions.
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